Is 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester? Is 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester safe for nursing mother and child? Does 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester extracts into breast milk? Does 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester has any long term or short term side effects on infants? Can 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester influence milk supply or can 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester decrease milk supply in lactating mothers?

Analgesic opioid used on anesthesic procedures.

Because the half-life of 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester is extremely short, it is unlikely to cause any adverse effects in the breastfed newborn if it is given to the mother for labor analgesia or a surgical procedure. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. Once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester to a few days. However, because no information is available on the use of 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester during breastfeeding, an alternate drug may be preferred if the mother requires prolonged administration of 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester during the early postpartum period. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately.

Four mothers who were breastfeeding their infants received 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester as part of their general anesthesia for surgical procedures. All patients also receved intravenous propofol and rocuronium, and inhaled xenon as part of the anesthesia. They were given doses of 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester that targeted a serum concentration of 4.5 mcg/L during the procedure and reduced to achieve a target concentration of 1.5 mcg/L at the end of anesthesia. Individual infants were first breastfed as follows: 1.5 hours, 2.8 hours, 4.6 hours, and 5 hours after extubation. No signs of sedation were observed in any of the infants.[1]

Narcotics can increase serum prolactin.[2][3] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed. A double-blind, randomized study compared patient-controlled intravenous (IV) analgesia with 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester (n = 43) to a continuous meperidine infusion (n = 45) for labor analgesia. Patients receiving 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester used an average total dosage of 1035 mcg/kg and those receiving meperidine received an average total dosage of 150 mg/kg. Breastfeeding difficulties were experienced in 6.3% of the infants of mothers who received 4-carboxy-4-(n-phenylpropionamido)-1-piperidinepropionic acid dimethyl ester and 12.8% of infants whose mothers received meperidine; however, this difference was not statistically significant.[4]